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ELECTRICAL PERMIT APPLICATION <br /> _ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA.98201 <br /> (P)425-257-8810 6 FAX 425-25? 8857 I (E)everetteps@everettwa.gov 1 vomiv.everattwa,gpyiperrrilts <br /> PROJECT ADDRESS: Si bb q i 112. . `L,-, P .... <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: gSFRDETACHED 0 SFR.ATTACHED 0 DUPLEX 0,MULTI-FAMILY->#OF UNITS: 0 COMMERCIAL. <br /> USE OF BUILDING: <br /> � 53 3 y g4 � 8 <br /> CONTRACT PRICE OF WORK:$ 100 <br /> NUMBER OF DEVICES(If"low voita9e) <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: -' . tet....te*::cca......Q. - fo-i <br /> k c° It F• ; < .,- T1Ctil M�It t .: 1 a ,: si. - 4 <br /> OWNER NAME: c...\cm-ccs. TENANT NAME(if Commercial): <br /> OWNER MAILINGS ADDRESS: STREETtelt) Lcs. 1 e <br /> cm, A, STATE \t1/444.., ZIP 4/ ),,2.0.g, <br /> OWNER PHONE: 4-2'-'*.k t. 2Z. t OWNER EMAIL: <br /> CONTRACTOR NAME: .! . -f3Y�1 IR �? <br /> CONTRACTOR ADDRESS: STREET 4 4 <br /> "fir t"1 <br /> CITY' i.GA i k. ... ,,,[ STATE I+ A. ZIP -. <br /> 9-0 <br /> CONTRACTOR PHONE: - •)C�. [CONTRACTOR EMAIL: . ;, K , <br /> `CONTRACTOR LIC.#(REQUIRED): '4 ` O? 2 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): , <br /> PRIMARY CONTACT: 0 OWNER II CONTRACTOR 0 OTHER(Please Specify) <br /> CONT,CT NAME: CONTACT PHONE: ° <br /> f # k CONTACT EMAIL: _I C 'y l . .., <br /> AGREEMENT:I thereby certify that I have read and examined this application and know the.same to be trite and correct. Ali provisions of laws and ordinances go ing this type` <br /> of work wit/be completed whether specified herein orno€ The granting of a permit does not presume to.give authority to violate or cancel the pmvisions of any other state or <br /> local taw regulating construction or the performance of construction: That I am authored by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18,27 RCW and 296.200 WAG. <br /> City of Everett Ofiai Use Only <br /> r <br /> PERMIT <br /> E '9:.Oct - (2-, <br /> (-)t it\k <br /> Owner/, horixeli Ag nt%Signature' Data (Revised 9l23r20TO <br />